PICOT, Problem Statement, Research Question, NOT FOR SALE

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PICOT, Problem Statement, Research Question, © Jones & Bartlett Learning, LLC Hypothesis NOT FOR SALE OR DISTRIBUTION

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LucyLLC B. Trice and Kathaleen C. © Jones & Bartlett Learning, ©Bloom Jones & Bartl NOT FOR SALE NOT FOR SALE OR DISTRIBUTION

Jones & Bartlett Learning, LLC Chapter Objectives OT FOR SALE OR DISTRIBUTION


At the conclusion of this chapter, the learner will be able to 1. Discuss processes involved in identifying a researchable problem in nursing practice

lett Learning, LLC Jones & Bartlett Learning, LLC 2. Write an effective problem© statement E OR DISTRIBUTION NOT FOR DISTRIBUTION 3. Discuss essential characteristics neededSALE to pose OR a research question 4. Identify the criteria for establishing research variables 5. Contrast the various types of hypotheses 6. Explain the differences between conceptual and operational definitions

© Jones & Bartlett LLCand hypotheses found in research © Jones & Bartl 7. Critically evaluate Learning, research questions reports for their contribution to the strength of evidence for nursing practice NOT FOR SALE NOT FOR SALE OR DISTRIBUTION

Key Terms

Jones & Bartlett Learning, LLC ➤ Associative hypothesis OT FOR SALE OR DISTRIBUTION


➤ Complex hypothesis

➤ Categorical variable

➤ Confounding variable

➤ Causal hypothesis

➤ Continuous variable

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122 | Chapter 5 PICOT, Problem Statement, Research Question, Hypothesis

© Jones & Bartlett Learning, LLC © Jones & Bartl FOR SALE ➤ NOT Demographic variable OR DISTRIBUTION ➤ Nondirectional hypothesis NOT FOR SALE ➤ Dependent variable

➤ Null hypothesis

➤ Dichotomous variable

➤ Problem statement

➤ Directional hypothesis

➤ Research hypothesis

Jones & Bartlett Learning, LLC ➤ Discrete variable OT FOR SALE OR DISTRIBUTION


➤ Research question

➤ Extraneous variable

➤ Simple hypothesis

➤ Hypothesis

➤ Variable

➤ Independent variable



© Jones & Bartlett Learning, LLC Introduction


© Jones & Bartl NOT FOR SALE

Every research study begins with a problem the researcher would like to solve. For such a problem to be researchable, it must be one that can be studied through collecting and analyzing data. Some problems, although interesting, are by their nature not appropriate research because they are not researchable. © Problems moralLearning, Jones & Bartlettproblems Learning, LLC Jonesinvolving & Bartlett or ethical issues are not researchable, as theNOT solutions these probOT FOR SALE OR DISTRIBUTION FORtoSALE OR DISTRIB lems are based on an individual’s values. For example, one could not research a question such as “Should marijuana use be legalized?” because the answer to the question depends on one’s values rather than on a clearly right or wrong answer. This is not to say that marijuana use cannot be studied. One could study people’s opinions lett Learning, LLC © Jones & Bartlett Learning, LLC regarding marijuana use. For example, one might ask the question, E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION “Do cancer patients hold more favorable opinions regarding legalization of marijuana use than the general public?” The need to avoid moral/ethical questions as a research topic applies to both quantitative and qualitative studies. factors influence whether using & Bartl © JonesOther & Bartlett Learning, LLC a problem is researchable © Jones quantitative methods. For a problem to be considered researchable NOT by FOR SALE NOT FOR SALE OR DISTRIBUTION quantitative methods, the variables to be studied must be clearly defined and measurable. This clarity is necessary to apply statistical measures that will identify relationships among the variables. Qualitative studies are not subject to the same restriction, as the purpose of studies isLLC to describe in detail the phenomenon as itLearning, Jones & Bartlettthese Learning, © Jones of & interest Bartlett is perceived by the study subjects. In other words, qualitative studies OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB are descriptive in nature and are not concerned with relationships among variables.

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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Introduction | 123

© Jones & Bartlett Learning, LLC NOT Identifying FOR SALE OR DISTRIBUTION Researchable Problems


There are a number of sources from which researchable problems can arise. Personal experience, whether as a healthcare professional or as a consumer of health care, is a rich source. For example, procedure theJones question, “Does oneLearning, Jones & Bartlettreviewing Learning, LLC manuals might raise © & Bartlett procedure for giving mouth care apply to all patients?” In considerOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB ing such diverse groups of patients as those with endotracheal or nasogastric tubes in place; those with full-blown AIDS, often accompanied by buccal mucosal lesions; and cancer patients on chemotherapy, one might ask, “Does one size fit all, or should separate procedures be established©for each case?” Thus, Learning, as many authors lett Learning, LLC Jones & Bartlett LLC point out (Macnee & McCabe, 2010; Polit & Beck, E OR DISTRIBUTION NOT2008; FORNorwood, SALE OR DISTRIBUTION 2010; Schmidt & Brown, 2012), practice experience is a major source for identifying gaps in knowledge that would benefit from research. The nursing literature can also be a valuable source for researchable & problems, the novice researcher (Burns & & Bartl © Jones Bartlettparticularly Learning,for LLC © Jones 2007; Norwood, 2010; Polit & Beck, 2010). For example, NOT FOR SALE NOT Grove, FOR SALE OR DISTRIBUTION the researcher might identify a topic of interest and then review the nursing research literature to determine which kinds of studies have been done in that area. Seeing how other researchers have approached a problem can often spark new ideas or perhaps point studies that LLC would benefit from replication. In addition to offer-Learning, Jones & BartletttoLearning, © Jones & Bartlett ingDISTRIBUTION such indirect assistance in the development of SALE a problem OT FOR SALE OR NOT FOR OR DISTRIB statement, the research literature, including unpublished dissertations and theses as well as published research articles, provides direct assistance through specific suggestions for future research in the area. These suggestions may be offered under a special heading for future research, or they may be & part of the discussion the lett Learning, LLC © Jones Bartlett Learning,ofLLC findings. E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Social issues often give rise to topics relevant to healthcare research (Norwood, 2010; Polit & Beck, 2008, 2010). For example, the feminist movement raised questions about gender equity in health care and in healthcare research. The civil rights movement led to research on minority health problems © Jones & Bartlett Learning, LLC in general and to explorations © Jones & Bartl of the differences in effectiveness of medical treatment in different NOT FOR SALE NOT FOR SALE OR DISTRIBUTION ethnic groups. Shifts in the U.S. population including increasing numbers of elderly, and increasing numbers of individuals with one or more chronic diseases, also provide impetus for healthcare research. For the emergence as Alzheimer’s Disease hasLearning, Jones & Bartlettexample Learning, LLC of conditions such © Jones & Bartlett led to research dealing with the nursing care of these patients, well DISTRIB OT FOR SALE OR DISTRIBUTION NOT FOR SALEas OR as research in how best to give “care for the caregiver” (Elliott, Burgio, & DeCoster, 2010). The rising epidemic of obesity at all ages of the

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© Jones & Bartlett Learning, LLC © Jones & Bartl FOR SALE NOT population, FOR SALE OR DISTRIBUTION and especially in childhood, highlights the NOT need for

research into methods to promote skill building with regard to healthy lifestyles (Melnyk, 2008). The Institute of Medicine’s report on professional education suggests that these shifts in population and changing of our society also demand a revamping of professional education Jones & Bartlettface Learning, LLC © Jones & Bartlett Learning, to better deal with these issues (Institute of Medicine Board on Health OT FOR SALE OR NOT FOR SALE OR DISTRIB CareDISTRIBUTION Services, 2003).

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Think Outside the Box

lett Learning, LLC © Jones & Bartlett Learning, LLC Using the following examples, develop problem statements, research E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

questions, and/or hypotheses for each one. (1) Which information has been used to determine the method of catheterizing a laboring mother? (2) Which information serves as the basis for the range of blood sugars used within newly diagnosed elderly diabetics? (3) Which items&need to be included into the formation of a problem statement, © Jones Bartlett Learning, LLC © Jones & Bartl research question, hypothesis? NOT FOR SALE NOT FOR SALE ORand DISTRIBUTION

The research priorities of the profession, and particularly of the funding bodies interested in healthcare research, are also a primary Jones & Bartlettsource Learning, LLC researchable problems © (Burns Jones&&Grove, Bartlett for generating 2011;Learning, Norwood, 2010). For example, the National of Nursing OT FOR SALE OR DISTRIBUTION NOTInstitute FOR SALE OR DISTRIB Research (NINR, n.d.) is the largest federal funding body dedicated specifically to nursing research. The NINR has as its mission “to promote and improve the health of individuals, families, communities, and populations” (p. 4). The Institute supports both clinical and basic research, and also provides funding for researcher training.LLC The lett Learning, LLC © Jones & Bartlett Learning, ongoing funding priorities of the NINR are listed in Table 5-1. E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Further elaboration within each priority is provided in the NINR strategic plan located on the Institute’s website: http://www.ninr.nih. gov/AboutNINR/NINRMissionandStrategicPlan

© Jones & Bartlett Learning, LLC Table 5-1 NOT FOR SALE OR DISTRIBUTION


Funding Priorities of NINR 1. Health Promotion and Disease Prevention 2. Advancing Quality of Life: Symptom Management 3. Palliative and End-of-Life Care 4. Innovation



Source: National Institute of Nursing Research (NINR). (n.d.). NINR mission. Retrieved from http://www.ninr.nih.gov/AboutNINR/NINRMissionandStrategicPlan

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Determining Significance of the Problem


Once the problem of interest has been identified, and before going any further, the researcher must determine the significance of the to nursing studying&the problem.Learning, Jones & Bartlettproblem Learning, LLCas well as the feasibility©ofJones Bartlett Significance refers to whether a problem is worth studying. A number OT FOR SALE OR DISTRIBUTION NOT SALE OR of authors agree on the criteria that can be usedFOR to determine the DISTRIB significance of a problem to nursing (Burns & Grove, 2011; LoBiondo-Wood & Haber, 2010; Polit & Beck, 2008): ■ Will nursing’s stakeholders (patients, nurses, healthcare com-

lett Learning, LLC munity) benefit from © Jones & Bartlett Learning, LLC the findings of the study? be applicable to practice, education, or ■ Will the findings NOT E OR DISTRIBUTION FOR SALE OR DISTRIBUTION

administration? ■ Will the findings extend or support current theory, or generate new theory? ■ Will the findings support current nursing practice or provide © Jones &evidence BartlettforLearning, LLC practice and/or policies? © Jones & Bartl changing current

FOR SALE NOT Some FORauthorities SALE OR DISTRIBUTION recommend that two additional criteria beNOT considered when determining the significance of a problem:

■ Will the findings address nursing research priorities? (Burns & Grove, 2007; Polit & Beck, 2010) Jones & Bartlett Learning, Jones Bartlett results of the proposed © study build&on previousLearning, ■ Will theLLC findings? (Burns & Grove, 2011; Polit & Beck, 2010) OT FOR SALE OR DISTRIBUTION NOT FOR2008, SALE OR DISTRIB

If the research problem does not meet the majority of these c riteria, it should be reworked or, if that is not possible, simply abandoned. The single most important of these criteria is perhaps the first one: Will nursing’s stakeholders (patients, nurses, healthcare comlett Learning, LLC © Jones & Bartlett Learning, LLC munity) benefit from the findings of the study? If this question cannot E OR DISTRIBUTION NOT“yes,” FOR then SALE DISTRIBUTION be answered with a resounding the OR problem is probably not worth studying. Nursing is a discipline that takes pride in research aimed at benefitting patients and changing practice for the better. In the move to evidence-based practice (EBP), benefit to patients and applicability to practice—and especially support for current practice © Jones & Bartlett Learning, LLC © Jones & Bartl or evidence for changing current practice—are paramount in assessNOT FOR SALE NOT ing FOR OR DISTRIBUTION theSALE significance of a research problem. According to Farrell (2006), “Practices are sorely needed that are based on sound evidence” (p. 119).

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, Examining Feasibility of the Problem OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB Feasibility refers to whether the study can be done. It includes considerations such as cost of the study, availability of study subjects, time

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT constraints, FOR SALE OR DISTRIBUTION availability of facilities and equipment, cooperation of others, interest of the researcher, and expertise of the researcher (Burns & Grove, 2009, 2011; LoBiondo-Wood & Haber, 2010; Norwood, 2010; Polit & Beck, 2008).

Jones & Bartlett Learning, LLC Cost OT FOR SALE OR DISTRIBUTION


EBP has emerged from the desire of the majority of healthcare providers (both institutions and individuals) to do what is right for the patient and what will result in more good than harm (Craig & Smyth, 2002). The evidence for EBP&isBartlett gathered through research lett Learning, LLC © Jones Learning, LLC (DiCenso, Guyatt, & Ciliska, 2005; Schmidt & Brown, 2012)—and E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION all research studies cost money to some degree. It is the researcher’s task to obtain support for the research from the institution in which it will be conducted as well as from potential funding bodies, both within the institution itself and in outside agencies. When&seeking this support, the researcher must present©aJones clear & Bartl © Jones Bartlett Learning, LLC picture of the value of the research in terms of patient outcomes NOT FOR SALE NOT versus FOR SALE ORinvolved. DISTRIBUTION the costs The current economic climate, which emphasizes the link between outcomes value and resources expenditure, demands nothing less (Malloch & Porter-O’Grady, 2006). In the final analysis, the deciding factor with regard to feasibility a particular LLC study may be how much the study will cost versusLearning, Jones & BartlettofLearning, © Jones & Bartlett the funds and other necessary support that are available to the OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB researcher. Availability of Subjects

The type and number of study subjects will vary depending on the

lett Learning, LLC Jones & numbers BartlettofLearning, purpose and design of the© study. Larger participantsLLC are E OR DISTRIBUTION NOT FOR SALE DISTRIBUTION generally needed for quantitative studies if theOR findings are to be considered significant, whereas smaller numbers of subjects are appropriate for studies using a qualitative design. Clearly, a sufficient number of subjects must be available for the study to be feasible.

© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Time Constraints


Studies done in connection with the pursuit of academic degrees (e.g., research projects, theses, dissertations), of necessity, have a time frame for their completion. The same is true for studies supJones & Bartlettported Learning, LLC © Jones & Bartlett Learning, by grant monies, as well as studies for which grant monies OT FOR SALE OR NOTfeasible, FOR SALE are DISTRIBUTION being sought. For a study to be considered it must OR have DISTRIB the possibility of being completed within the applicable time constraints.

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© Jones & Bartlett Learning, LLC NOT Availability FOR SALE OR DISTRIBUTION of Facilities and Equipment


The need for special facilities and equipment can add greatly to the cost of a study. Although not all studies require specialized equipment or facilities, for those that do, both the cost and the availability of items must be taken into consideration when determining theLearning, Jones & Bartlettthese Learning, LLC © Jones & Bartlett feasibility of the study. OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB Cooperation of Others

All studies require a certain amount of cooperation from others. The researcher may need referrals from others to obtain Learning, research subjects, lett Learning, LLC © Jones & Bartlett LLC for example, or to arrange for use of laboratories or other kinds of E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION facilities. Student researchers in particular often need assistance with data entry in quantitative studies, data transcription in qualitative studies, and statistical analysis. These types of assistance are frequently offered to student researchers without a fee; however, obtaining the assistance requires Learning, cooperation LLC from those providing these©services. © Jones & Bartlett Jones & Bartl The study subjects themselves must also cooperate in a sense, if the NOT FOR SALE NOT FOR SALE OR DISTRIBUTION data are to be collected in a timely manner. Thus cooperation of these important others is an essential ingredient of a feasible study. Securing that cooperation falls squarely on the shoulders of the researcher. In their discussion of obtaining cooperation from various others, Burns Grove (2001) contend that researchers need to maintain objectiv-Learning, Jones & Bartlettand Learning, LLC © Jones & Bartlett ity throughout the course of the study, avoiding a tendency to OR take DISTRIB OT FOR SALE OR DISTRIBUTION NOT FOR SALE themselves too seriously; “a sense of humor is invaluable” (p. 426). Interest of the Researcher

Conducting research, although often rewarding when the final results lett Learning, LLC © Jones & Bartlett Learning, LLC are in, is nevertheless hard work. To embark on a study that is not of E OR DISTRIBUTION FOR SALE OR DISTRIBUTION fairly profound interest to NOT the researcher is foolhardy at best, and at worst it can lead to failure to complete the study. If the researcher is not interested in doing the research, then carrying out the study is not generally feasible.

© Jones & Bartlett Learning, LLC of theOR Researcher NOT Expertise FOR SALE DISTRIBUTION


Ideally, the researcher should have prior knowledge and experience in the field of study in question. This is not to say that a study would be considered not possible solely because it is a new area of study for the researcher. Certainly, seasoned researchers frequently “branch out” Jones & Bartlettinto Learning, LLC © Jones & Bartlett Learning, new areas of study. When less experienced researchers are OT FOR SALE OR DISTRIBUTION NOT that FOR SALE OR involved, however, Polit and Beck (2008) caution difficulties may DISTRIB arise in developing and carrying out a study on a topic that is totally new and/or unfamiliar.

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Addressing Nursing Research Priorities


If the body of knowledge that deals with the practice of nursing is to be expanded, the major focus of nursing research should be on issues influence patient through&this type ofLearning, Jones & Bartlettthat Learning, LLC outcomes. Further, it©isJones Bartlett research that we will gather the evidence to document the quality and OT FOR SALE OR DISTRIBUTION NOT FOR OR DISTRIB effectiveness of nursing care (Moorhead, Johnson, Maas,SALE & Swanson 2008). The specific areas of focus, in terms of patient outcomes, vary widely. As noted elsewhere, doing research can be costly, so it behooves the researcher to attempt to match his or her research interests not only with those of the institution©where the & individual works, but also with lett Learning, LLC Jones Bartlett Learning, LLC the priorities established by funding agencies.The major federal funding E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION agency dedicated to nursing is NINR. Other funding bodies with research priorities relevant to nursing include the Agency for Healthcare Research and Quality; private organizations such as the Kellogg Foundation and the Helene Fuld Health Trust; professional organizations such as the&American Nurses Foundation and Sigma Theta Tau International; © Jones Bartlett Learning, LLC © Jones & Bartl and nursing specialty organizations such as the Association of PeriopNOTCare FOR SALE NOT erative FOR SALE OR DISTRIBUTION Registered Nurses and the American Association of Critical Nurses, to name a few. Taking care to address the funding priorities of a particular organization enhances the possibility of obtaining from that organization the funding needed to complete the research project.


Problem Statement


The problem statement presents the idea, issue, or situation that the researcher intends to examine in the study.The statement should be broad enough to cover the concern prompting the study, yet narrow enough lett Learning, LLC © Jones & Bartlett Learning, LLC to provide direction for designing the study. It can be conceptualized in E OR DISTRIBUTION NOT or FOR SALEInOR the form of a declarative sentence a question. someDISTRIBUTION cases, the term “research question” is used interchangeably with “problem statement.”

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Think Outside the Box © Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT FOR SALE OR DISTRIBUTION Formulate a conceptual and operational definition for catheterization, laboring mother, blood sugar, and newly diagnosed elderly diabetic.

The problem statement is the foundation of the study, and as such

Jones & Bartlettis Learning, LLC © Jones & Bartlett Learning, usually preceded by several paragraphs of background information OT FOR SALE OR NOT FOR SALE thatDISTRIBUTION set the stage for the proposed study. These paragraphs identifyOR the DISTRIB significance of the problem, present justification that the problem is researchable, and provide supporting documentation from the literature.

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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Research Question | 129

© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT This FOR SALE OR DISTRIBUTION general discussion of the problem culminates in the problem statement. The problem statement is often further clarified by including the purpose and goal(s) of the study, all of which are derived from the problem statement.

Jones & Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Research Question


Although the terms “research question” and “problem statement” are sometimes used interchangeably, the research question is often more specific than the problem statement. Additionally, research queslett Learning, LLC © Jones & Bartlett Learning, LLC tions (rather than hypotheses) are frequently used to guide studies E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION that are exploratory in nature and aimed at describing variables or perhaps identifying differences between groups in relation to these variables. Research questions also guide studies that examine relationships among the variables being studied but do not test the nature of these & relationships. Studies designed relation© Jones Bartlett Learning, LLCto test the nature of the© Jones & Bartl ships among variables are generally guided by hypotheses rather than NOT FOR SALE NOT research FOR SALE OR DISTRIBUTION questions (Burns & Grove, 2009; Fain, 2009). Research questions can be used to guide both quantitative and qualitative studies. Quantitative studies are often initiated to answer several questions derived from the problem of interest, each focused a specific variable population. example,Learning, Jones & BartlettonLearning, LLC to be measured in the© Jones &For Bartlett West et al. (2011) were interested in obesity prevention, and speOT FOR SALE OR DISTRIBUTION NOT FORlost SALE ORa DISTRIB cifically how to prevent regaining weight initially during weight loss regimen. Most weight loss methods focus on behavioral skill refinement, i.e., changing food choice and/or eating patterns. These same methods are used in maintenance programs, but with disappointing results (Wing et al., 2008). West and her colleagues lett Learning, LLC © Jones & Bartlett Learning, LLC devised a study to compare the efficacy of a motivation-focused E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION treatment versus a skill-based treatment in maintaining weight loss (2011). The following research questions might be used to guide this study: 1. Does a motivation-focused intervention affect weight mainte-

in individuals who have © Jonesnance & Bartlett Learning, LLCrecently lost weight? © Jones & Bartl 2. Does a skill-based intervention affect weight maintenance in NOT FOR SALE NOT FOR SALE OR DISTRIBUTION individuals who have recently lost weight? 3. Do individuals who follow a motivation-focused intervention maintain their weight loss for a longer time period than those who follow a skill-based intervention?

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, Questions 1 and 2 are narrowly focused, dealing with one OT FOR SALE OR DISTRIBUTION FOR SALEinterOR DISTRIB independent variable (participation in a NOT motivation-focused vention and participation in a skill-based intervention, respectively) and the dependent variable (weight maintenance).The third question,

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT while FOR more SALE OR DISTRIBUTION complex, gets at the heart of the matter: Does one inter-

vention work better than the other? Qualitative studies, by their nature, explore phenomena about which little is known. Burns and Grove (2007) point out that the questions guiding these types of studies are limited in number Jones & Bartlettresearch Learning, LLC © Jones & Bartlett Learning, and generally broad in scope, and they include variables or concepts OT FOR SALE OR FOR SALE thatDISTRIBUTION are more complex than those guidingNOT quantitative studies.OR For DISTRIB example, Karlsson, Bergbom, and Forsberg (2012) investigated the lived experiences of adult intensive care patients who were conscious while undergoing mechanical ventilation. Using a qualitative approach (namely phenomenology),©they conducted in-depthLearning, interviews with lett Learning, LLC Jones & Bartlett LLC 12 patients who were determined to be conscious while they were E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION being mechanically ventilated. The interviews took place approximately 1 week following their discharge from the intensive care unit. The research question guiding this study might be stated as follows: What are the essential themes common to the experience of being conscious while undergoing mechanical in & Bartl © Jones & Bartlett Learning, LLC ventilation? The concepts © Jones this question are much broader than those cited for the earlier quanNOT FOR SALE NOT titative FOR SALE DISTRIBUTION example.OR Qualitative studies, because they are designed to get at understanding behavior and the values/perceptions that underlie it are particularly important as a starting point for designing and implementing nursing interventions (Ketefian & Redman, 2013).

Jones & Bartlett Learning, LLC Components of the Problem Statement OT FOR SALE OR DISTRIBUTION


A well-written problem statement for a quantitative study, whether written as a declarative statement or a question, has at a minimum, two components: the population of concern and the variable(s) to be studied. The PICOT format described elsewhere, has the advantage of lett Learning, LLC © Jonesof&the Bartlett LLC clarifying more fully the population study as Learning, well as the interE OR DISTRIBUTION NOT the FOR SALEdesired, OR DISTRIBUTION vention/comparison of interest, outcome and the time frame involved. For example, a researcher might be interested in investigating the use of pet therapy to increase morale in hospitalized patients. As stated, the population (hospitalized patients) is fairly broad and does not provide a lot of direction for the literature search © Jones Bartlett Learning, LLCon the specific concern©and Jones or for&the study design. Depending age & Bartl FOR SALE NOT group FOR under SALEinvestigation, OR DISTRIBUTION the researcher could narrow theNOT population by age (e.g., hospitalized patients between the ages of 6 and 10 years) or other characteristics, such as disease and/or treatment (e.g., hospitalized patients between the ages of 6 and 10 years undergoing treatment for cancer). The variables of interest would be pet Jones & Bartletttherapy Learning, LLC © Jones & Bartlett Learning, and morale. Following the PICOT format, the population of OT FOR SALE OR DISTRIBUTION NOT FOR SALE interest (P) would be hospitalized patients between the ages of 6OR and DISTRIB 10 years undergoing treatment for cancer; the intervention of interest (I) would be pet therapy; the comparison of interest (C) would be

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT no FOR petSALE therapy;OR theDISTRIBUTION outcome of interest (O) would be increased

morale; and the time (T) would refer to time of hospitalization. Strictly speaking, the term “variable” refers to measurable qualities or characteristics of people, things, or situations that can change, or fluctuate. For example, blood pressure, pulse rate, anxiety Jones & Bartlettvary, Learning, LLC © Jones & Bartlett Learning, level, and degree of pain are all characteristics of people that can vary OT FOR SALE OR DISTRIBUTION NOTtoFOR SALE OR from one person to another. A child’s reaction the presence (or DISTRIB absence) of a parent in the hospitalized child’s room during painful procedures can vary from one hospitalized child to another. Variables are the foundation of quantitative studies; they constitute what is being studied in the designated population. lett Learning, LLC © Jones & Bartlett Learning, LLC Researchers often want to know what causes or influences a parE OR DISTRIBUTION NOT FOR SALE ORorDISTRIBUTION ticular phenomenon or, in some cases, what alleviates diminishes that phenomenon. For example, one might want to know if a hospitalized child’s anxiety level during a painful procedure would be lessened if a parent were present during the procedure. In this case, there are two variables of interest:Learning, the child’s anxiety parent & Bartl © Jones & Bartlett LLC level and the presence of©a Jones during the painful procedure. The researcher is investigating the effect SALE NOT that FOR OR theSALE presence of DISTRIBUTION a parent has on the child’s anxiety level NOT duringFOR a painful procedure. Because the variable “presence of a parent” is having an effect on the variable “child’s anxiety level,” it is termed the independent variable. By the same token, the variable being affected (i.e., child’s level) isLLC termed the dependent variable. In a study Jones & Bartlettanxiety Learning, © Jones & investigating Bartlett Learning, more than one variable, the variable(s) that is (are) acting on, influencOT FOR SALE OR DISTRIBUTION NOT FOR SALE ing, or causing an effect on the other variable(s) is (are) calledOR the DISTRIB independent variable(s), and the variable(s) being acted on is (are) called the dependent variable(s) (Burns & Grove, 2011; LoBiondo-Wood & Haber, 2010; Norwood, 2010; Polit & Beck, 2010). Other types of variables that can affect the outcome of the study lett Learning, LLC Jones &is Bartlett Learning, LLC but are not the variables the©researcher investigating are referred to E OR DISTRIBUTION FOR SALE OR DISTRIBUTION as extraneous variables. InNOT the example cited earlier, the age of the child could affect his or her anxiety level, regardless of whether a parent is present in the room, and therefore would be considered an extraneous variable. The researcher could control for the variable of age by limiting the study population to a particular age group. Another © Jones & that Bartlett LLC Jones & Bartl variable might Learning, affect the child’s anxiety level, regardless of© whether NOT FOR SALE NOT aFOR ORinDISTRIBUTION parentSALE is present the room, is the nature of the painful procedure. The procedure could be specified to control for this variable. With any study, it is important to identify and control for extraneous variables; otherwise, the study results may be confusing and inaccurate. Most studies have extraneous variables of one sort or another. It is important Jones & BartlettforLearning, LLC © Jones & Bartlett Learning, the researcher to recognize and control for these variables, either OT FOR SALE OR DISTRIBUTION NOT FOR in the study design or through statistical procedures, to SALE preserveOR the DISTRIB validity of the study results. If a study cannot control for an extraneous variable, the variable is then termed a confounding variable.

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT FOR SALE OR DISTRIBUTION The term “demographic variable” refers to characteristics of the

subjects in the study. Data on these characteristics are usually collected during the study and are then used to describe the study group. Many different kinds of demographic information can be collected, including about age, gender, ethnicity, educational level, marital status, Jones & Bartlettdetails Learning, LLC © Jones & Bartlett Learning, and number of children. The types of demographic data collected OT FOR SALE OR DISTRIBUTION NOT SALE depend on the purpose of the study; however, at a FOR minimum, dataOR on DISTRIB age, gender, and ethnicity should be gathered.


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© Outside Jones & Think theBartlett Box

Learning, LLC NOT FOR SALE OR DISTRIBUTION

Why is it necessary to have a problem statement, research question, or hypothesis? What benefit does it provide? Is one better than others? Which restrictions arise related to the use of the problem statement, research question, or hypothesis?



If a variable can take on a wide range of values (from 0 to 100 or larger), it is often referred to as a continuous variable. A continuous variable is not limited to whole-number values. Examples of continuous include age, weight, salary, and ©blood pressure. In con-Learning, Jones & Bartlettvariables Learning, LLC Jones & Bartlett trast, variables that can take on only a finite number of values, usually OT FOR SALE OR DISTRIBUTION FORvariables. SALE OR restricted to whole numbers, are referred toNOT as discrete For DISTRIB example, respiratory rate would be considered a discrete variable, as it can take on only whole-number equivalents; although variation in respiratory rate can occur from person to person, a finite number of these variations are compatible with life. lett Learning, LLC Categorical and dichotomous © Jones & Bartlett Learning, variables are similar because LLC they E OR DISTRIBUTION NOT SALEonly OR inDISTRIBUTION represent characteristics that can FOR be measured the sense that they are either present or not present. These kinds of variables are often assigned a number for identification, but the number does not represent a quantity. For example, ethnicity might be divided into white, African American, Hispanic, Native American, Pacific Islander, © Jones & Bartlett Learning, © Jones & Bartl and Asian American, with each LLC classification assigned an identifying FOR SALE NOT number. FOR SALE OR DISTRIBUTION The assigned number, however, would have no NOT meaning other than identifying the occurrence of each race, perhaps to facilitate counting the number of occurrences of that particular race in the study. In this case, race would be considered a categorical variable, with each race included in the study representing a category. If only Jones & Bartletttwo Learning, LLC © Jones & Bartlett Learning, categories are possible for a categorical variable, it may be referred OT FOR SALE OR DISTRIBUTION NOT FOR ORa DISTRIB to as a dichotomous variable. For example, gender is SALE considered dichotomous variable, as two categories are possible—male and female.

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Table 5-2

Problem Statements Declarative Statement Format

Question Format

Music therapy decreases the level of maternal Jones & Bartlett Learning, LLC anxiety during cesarean section. OT FOR SALE NursingOR home DISTRIBUTION residents who participate in


regular exercise have fewer falls than those who do not. Participation in a support group improves morale in family caregivers of Alzheimer’s patients. Diabetic patients who perceive of themselves as obese will participate in a weight management program. The number of medication errors made by nurses increases when the number of medications per patient is greater than three (3).


Does music therapy decrease the level of maternal anxiety during cesarean section? Do nursing home residents who participate in regular exercise have fewer falls than those who do not? Does participation in a support group improve morale in family caregivers of Alzheimer’s patients? Will diabetic patients who perceive of themselves as obese participate in a weight management program? Does the number of medication errors made by nurses increase when the number of medications per patient is greater than three (3)?


© Jones & the Bartlett Learning, © Jones & Bartl Writing Problem Statement LLC NOT FOR SALE NOT As FOR SALE OR DISTRIBUTION noted previously, problem statements for quantitative studies may

be written in the form of a declarative statement or a question (Table 5-2). The two components that must be included in every problem statement are the population of interest and the variable(s) be measured. For example, if we were interested Jones & BartletttoLearning, LLC © Jonesin&studying BartletttheLearning, effect of presence of a parent on anxiety level in children undergoing OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB painful procedures, we might construct a problem statement in the form of a question: “Does the presence of a parent affect the anxiety level in children ages 3–5 years undergoing initiation of intravenous therapy?” Alternatively, the same problem could be stated as a declarative statement: “The presence of a parent affects the anxiety level in lett Learning, LLC © Jones & Bartlett Learning, LLC children ages 3–5 years undergoing initiation of intravenous therapy.” E OR DISTRIBUTION FOR SALE OR DISTRIBUTION Both statements contain NOT a population of interest (children ages 3–5 years undergoing initiation of intravenous therapy) and two variables (presence of a parent—independent variable; anxiety level of the child—dependent variable). The only difference between the two is the form of the statement—one is presented as a question and © Jones & Bartlett Learning, LLC © Jones & Bartl the other as a declarative statement. Note also that the elements of the NOT FOR SALE NOT PICOT FOR SALE ORreadily DISTRIBUTION format are apparent in each of these examples as well as those in Table 5-2.

?

Jones & Bartlett Learning, LLC Think Outside the Box © Jones & Bartlett Learning, OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB Identify the elements of the PICOT format for each of the problem statements in Table 5-2.

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Hypotheses


A research question asks whether a relationship exists between variables in a particular population. In contrast, a hypothesis stipulates predicts the LLC relationship that exists. For©example, researchLearning, Jones & BartlettorLearning, Jones if&the Bartlett question is “Does the presence of a parent in the room affect the OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB anxiety level in children ages 3–5 years undergoing initiation of intravenous therapy?”, then we might develop several hypotheses:

1. The presence of a parent in the room affects the anxiety level in children ages 3–5 years who undergo initiation of intravenous lett Learning, LLC therapy. © Jones & Bartlett Learning, LLC 2. The presence of a parent in FOR the room reduces anxiety level E OR DISTRIBUTION NOT SALE OR the DISTRIBUTION in children ages 3–5 years who undergo initiation of intravenous therapy. 3. The presence of a parent in the room has no effect on the anxiety level in children ages 3–5 years who undergo initiation of intra© Jonesvenous & Bartlett Learning, LLC © Jones & Bartl therapy. 4. The presence a parent in the room increases the anxiety NOTlevel FOR SALE NOT FOR SALE ORofDISTRIBUTION in children ages 3–5 years who undergo initiation of intravenous therapy.

The advantage of a hypothesis over a research question is that the hypothesis putsLLC the question into a form that can be tested. It is theLearning, Jones & Bartlett Learning, © Jones & Bartlett nature of hypotheses to predict relationships among or between variOT FOR SALE OR DISTRIBUTION NOT FORaSALE OR DISTRIB ables. For a hypothesis to be testable, it must stipulate relationship between at least two variables in a given population. Within EBP, the research question format incorporates the population of interest, the intervention, a comparison of interest, outcomes, and timing to ensure clarity of the subject (note that these are lett Learning, LLC © Jones & Bartlett Learning, LLC the components of the PICOT format). This process can also be applied E OR DISTRIBUTION NOT FOR SALE DISTRIBUTION to developing one or more hypotheses for a OR research study. Each hypothesis should contain the population of interest, the independent variable(s), the dependent variable(s), and the comparison of interest, all of which should lead to the outcome of the study.

© Jones & Bartlett Learning, LLC andOR Qualitative Studies NOT Hypotheses FOR SALE DISTRIBUTION


Hypotheses are used in quantitative studies but are not appropriate for qualitative studies. By their nature, they present the researcher’s opinion in the form of a prediction about the outcome of the study. In qualitative studies, however, researchers focus on the viewpoints of Jones & Bartlettthe Learning, LLC © Jones & Bartlett Learning, subjects participating in the study rather than on their own. Thus OT FOR SALE OR NOT FOR SALE OR DISTRIB theDISTRIBUTION participants’ viewpoints, rather than the researcher’s hypothesis, guide the qualitative study. Generally, the purpose of qualitative studies is to explore new concepts and ideas about which little is known, or

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© Jones & Bartlett Learning, LLC © Jones & Bartl FOR SALE NOT to FOR SALE DISTRIBUTION discover newOR meanings for concepts. In keeping with this NOT purpose,

researchers using qualitative methods take great care to set aside their preconceived notions about the phenomena under investigation. A hypothesis would be a disadvantage in a qualitative study, because it predict the outcome of the study and potentially bias the Jones & Bartlettwould Learning, LLC © Jones & Bartlett Learning, results. Thus, while qualitative studies may generate hypotheses that OT FOR SALE OR NOT OR DISTRIB can DISTRIBUTION then be tested using quantitative methods, theyFOR are notSALE themselves guided by research hypotheses. Types of Hypotheses

lett Learning, LLC © Jones & Bartlett Learning, LLC A testable hypothesis, also called the research hypothesis, predicts the E OR DISTRIBUTION SALE OR DISTRIBUTION relationship between two orNOT moreFOR variables in a population of interest. All four of the hypotheses in the previous example could be considered testable. Hypotheses may be directional, nondirectional, or null:

© Jones■ A & Bartlett Learning, LLC © Jones directional hypothesis predicts the path or direction the & Bartl relationship take. In the preceding example, bothNOT hypothFOR SALE NOT FOR SALE OR will DISTRIBUTION

esis 2 and hypothesis 4 are directional hypotheses. Hypothesis 2 predicts a decrease in anxiety with the presence of a parent, and hypothesis 4 predicts an increase in anxiety with the presence of a parent. Jones & Bartlett Learning, LLC © Jones & Bartlett hypothesis predicts a relationship but notLearning, ■ A nondirectional the path or direction of the relationship. 1 inOR the DISTRIB OT FOR SALE OR DISTRIBUTION NOTHypothesis FOR SALE previous example is a nondirectional hypothesis; it states that the presence of a parent affects the anxiety level in children ages 3–5 years but does not stipulate the direction of the effect. ■ A null hypothesis, also called a statistical hypothesis, predicts among or between the variables in lett Learning, LLC that no relationship©exists Jones & Bartlett Learning, LLC the study. When inferential statistics are used to analyze data, E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION the assumption is that the null hypothesis is actually being tested. Because this is understood, many researchers do not state the null hypothesis when reporting their findings in the literature. In the previous example, hypothesis 3 is stated in null form. © Jones &the Bartlett Learning, LLC © Jones & Bartl

NOT FOR SALE NOT FOR SALE OR Hypotheses mayDISTRIBUTION also be classified as simple or complex: A simple

hypothesis specifies the relationship between two variables, whereas a complex hypothesis specifies the relationships between and among more than two variables. In the previous example, all four of the hypotheses could be classified as simple hypotheses. In each case, Jones & Bartlettthere Learning, LLC © Jones & Bartlett Learning, are only two variables—the presence of a parent and the anxiety OT FOR SALE OR DISTRIBUTION FOR SALE OR DISTRIB level in children ages 3–5 years. An exampleNOT of a complex hypothesis might be “Religious beliefs, presence of social support, and ethnic background affect the perception of pain in patients who are terminally

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT the FOR SALE NOT ill FOR DISTRIBUTION withSALE cancer.”OR Here there are four variables—religious beliefs, presence of social support, ethnic background, and perception of pain. Complex hypotheses may also be termed multivariate hypotheses for the simple reason that they contain more than two variables.

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, OT FOR SALE OR DISTRIBUTIONThink Outside the Box NOT FOR SALE OR DISTRIB

?

Describe a problem in which a null hypothesis would be used and state the null hypothesis.

lett Learning, LLC © Jones & Bartlett Learning, LLC E OR DISTRIBUTION NOT SALE ORasDISTRIBUTION In addition, hypotheses mayFOR be categorized associative or

causal. These terms reflect the relationship between or among the variables in the hypothesis. For example, in an associative hypothesis, the hypothesis is stated in a way indicating that the variables exist side by side, and that a change in oneLLC variable is accompanied by © a change © Jones & Bartlett Learning, Jones & Bartl in another. However, there is no suggestion that a change in one variNOT SALE NOT able FOR SALE OR DISTRIBUTION causes a change in another—merely that the variables change FOR in association with each other (Reynolds, 1971). In contrast, a causal hypothesis is stated in a way indicating that one variable causes or brings about a change in one or more other (BurnsLLC & Grove, 2011). As one might expect, variableLearning, Jones & Bartlettvariables Learning, © Jones & the Bartlett inducing the change is referred to as the independent variable, and OT FOR SALE OR FOR SALE OR DISTRIB the DISTRIBUTION variable being changed is the dependentNOT variable. Causal hypotheses may also be called directional hypotheses. Continuing with the example of the presence of a parent in the room with a child during a painful procedure and its effect on the child’s anxiety level, two of the hypotheses can be termed causal—hypothesis 2 and hypothesis 4. lett Learning, LLC © Jones & Bartlett Learning, LLC Hypothesis 2 predicts a decrease in anxiety (dependent variable) with E OR DISTRIBUTION NOT OR DISTRIBUTION the presence of a parent in the FOR room SALE (independent variable), and hypothesis 4 predicts an increase in anxiety (dependent variable) with the presence of a parent in the room (independent variable).


Defining Variables for the Study


The variables to be studied in quantitative research projects are generally defined in two ways—conceptually and operationally. The conceptual definition is a broad, more abstract definition that is generally drawn from relevant literature, particularly the theoretical literature; Jones & Bartlettthe Learning, LLC © Jones & Bartlett Learning, researcher’s clinical experience; or, in some cases, a combination OT FOR SALE OR DISTRIBUTION FORto SALE OR DISTRIB of these sources. The conceptual definitionNOT is similar a dictionary definition in that it provides the general meaning associated with the variable, but it is more in-depth and broader in scope. Although

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT cFOR SALE DISTRIBUTION onsidered the OR starting point, conceptual definitions rarely give direc-

tion regarding how the variable will actually be measured for the study. The operational definition, by contrast, stipulates precisely how the variable will be measured, including which tools will be used, if If a conceptual definition is abstract, an operational definiJones & Bartlettapplicable. Learning, LLC © Jones & Bartlett Learning, tion is concrete. This concreteness is necessary to allow for precise OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB measurement of the variable(s) of interest in the study.

Evidence-Based Practice Considerations

lett Learning, LLC © Jones & Bartlett Learning, LLC Stommel and Wills (2004) point out that the ability to apply research E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION findings to practice is an expected competency of advanced practice

nurses. However, if we accept that it is the desire of all practitioners of nursing to provide “only that care that makes a positive difference in the lives of those whom they serve” (Porter-O’Grady, 2006, p. 1), then it&isBartlett clear thatLearning, all professional nurses—from the new graduate to & Bartl © Jones LLC © Jones the seasoned veteran—should have the ability to apply research findFOR SALE NOT ings FORtoSALE DISTRIBUTION practice.OR Inherent in this ability is an understandingNOT of how the research process unfolds and what constitutes good research. Further, Melnyk and Fineout-Overholt (2011) maintain that “the goal of EBP is to use the highest quality of [research] knowledge in care to produce the greatest impact©onJones patients’&health status”Learning, Jones & Bartlettproviding Learning, LLC Bartlett (p. 75). To accomplish this, practitioners—and particularly staff nurses OT FOR SALE OR FOR SALE OR whoDISTRIBUTION are at the bedside caring for patients onNOT a daily basis—must have DISTRIB the tools to critically analyze research so as to make appropriate EBP decisions. To critically analyze research, these staff nurses must possess a working knowledge of the language of research; recognize a researchable problem statement; distinguish between and among variables, lett Learning, LLC © Jones & Bartlett Learning, identifying independent versus dependent variables; determineLLC the E OR DISTRIBUTION NOTall, FOR SALEa well-conducted OR DISTRIBUTION population of interest; and above recognize study, one whose findings are worth consideration for applying to practice. In its purest and best form, EBP happens at the bedside. The burden of implementation rests squarely on the shoulders of the staff nurse. For more information on EBP, visit the following site: http:// © Jones & Bartlett Learning, LLC © Jones & Bartl journals.lww.com/ajnonline/pages/collectiondetails.aspx?Topical NOT FOR SALE NOT CollectionId=10 FOR SALE OR DISTRIBUTION

Summary Points

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, 1. Every study begins with a problem the researcher would like to solve. OT FOR SALE OR2. DISTRIBUTION NOT FOR SALE OR DISTRIB There are many sources for researchable problems, including personal

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experience, the nursing literature, social issues, and the research priorities of funding bodies.


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© Jones & Bartlett Learning, LLC © Jones & Bartl FOR SALE NOT OR of DISTRIBUTION FOR 3. TheSALE significance the problem to nursing and the feasibilityNOT of study-

ing the problem are important aspects to consider before embarking on any research project. 4. The problem statement presents the issue or situation to be examined and should identify the population of interest as well as the variables Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, that will be studied. OT FOR SALE NOT(a)FOR SALEversus OR DISTRIB OR5. DISTRIBUTION Variables may be classified in a variety of ways: independent dependent, (b) continuous versus discrete, (c) extraneous, (d) confounding, (e) categorical, and (f) dichotomous. 6. The problem statement may be written as a question or as a declarative sentence. lett Learning, LLC © Jones & Bartlett Learning, LLC 7. Placing the problem statement in the PICOT format helps to clarify the E OR DISTRIBUTION NOT FOR SALE DISTRIBUTION population, variables, outcome and time frame OR involved. 8. Hypotheses predict the relationship between or among variables. 9. Hypotheses may take many forms: (a) directional versus nondirectional, (b) simple versus complex, (c) associative versus causal, and (d) null. 10. Variables to be studied are generally defined both conceptually and © Jones & Bartlett Learning, LLC © Jones & Bartl operationally. NOT the FOR SALE NOT FOR SALE OR DISTRIBUTION 11. For nurses to pursue evidence-based practice, they must understand research process and all of its components.







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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Red Flags | 139



RED FLAGS • Quantitative studies address research problems, research questions, and/or

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, hypotheses. OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB • Qualitative studies do not use hypotheses, but rather explore research problems and research questions. If a qualitative study discusses a hypothesis, thought should be given to its focus and validity.

• A hypothesis must have at least © oneJones independent variable and one depenlett Learning, LLC & Bartlett Learning, LLC dent variable; it is usually stated inNOT a declarative statement format rather than E OR DISTRIBUTION FOR SALE OR DISTRIBUTION as a question. • Key variables within a study should have at least the operational definition provided for consideration.








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Multiple Choice Questions


1. Developing a research study to investigate the availability of health care for minority children whose families are on welfare is an example of a research problem generated primarily Jones & Bartlett Learning, LLC from © Jones & Bartlett Learning, OT FOR SALEA. ORPractice. DISTRIBUTION NOT FOR SALE OR DISTRIB B. Social issues. C. Healthcare trends in society. D. Theory.

2. Problems issues are¬ researchable because LLC lett Learning, LLC involving moral or ethical © Jones Bartlett Learning, A. They are too costly to perform. E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION B. Most researchers are not interested in these studies. C. They are based on individual values. D. Data collection is problematic.

3. Determining if studying the problem will lead to results that are applicable to © Jones & Bartlett Learning, LLC © Jones & Bartl nursing practice is essential when analyzing the _________ of the problem. NOT FOR SALE NOT FOR SALE OR DISTRIBUTION A. Feasibility B. Profitability C. Cost D. Significance

Jones & Bartlett Learning, LLC topics would be inappropriate © Jones 4. Which of the following for &a Bartlett researchableLearning, OT FOR SALEproblem? OR DISTRIBUTION NOT FOR SALE OR DISTRIB A. B. C. D.

The The The The

morality of abortion as a form of birth control relationship between cigarette smoking and weight loss effect of severe dietary restrictions on well-being relationship between religious beliefs and pain perception

lett Learning, LLC © Jones & Bartlett Learning, LLC 5. Which of the following is the best example of SALE a problem statement containing E OR DISTRIBUTION NOT FOR OR DISTRIBUTION

all parts of the PICOT format? A. Children whose parents stay with them experience less pain. B. Hospitalized patients who have a relative with them experience less pain than those who do not. © Jones & Bartlett Learning, LLC © Jones & Bartl C. Hospitalized children ages 3–5 years whose parents stay with them duringSALE painful OR procedures experience less pain than those who NOT do not.FOR SALE NOT FOR DISTRIBUTION D. Patients who have a relative with them during a transfusion will experience less anxiety than those who do not.

6. Which of the following best represents a well-constructed problem statement? A. What affects pain perception? Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, B. Obesity negatively impacts self-image in first graders.FOR SALE OR DISTRIB OT FOR SALE OR DISTRIBUTION NOT C. This study will compare the effectiveness of antacids. D. Does time of day affect appetite?

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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT SALEparts OR ofDISTRIBUTION 7. TheFOR two essential the research problem statement are the population and the A. Setting. B. Theory. C. Concepts. Bartlett Learning, D. Variables.

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8. The research question is “Obesity increases the risk of type 2 diabetes in teenage boys.” Which of the following is/are the independent variable(s)? A. Teenage boys with type 2 diabetes B. Gender and obesity lett Learning,C. LLC © Jones & Bartlett Learning, LLC Obesity E OR DISTRIBUTION FOR SALE OR DISTRIBUTION D. Type 2 diabetes, obesity, andNOT gender

9. The research question is “Does massage therapy increase satisfaction during cesarean delivery?” Which of the following is/are the dependent variable(s)? A. Massage therapy © Jones & Bartlett Learning, LLC © Jones & Bartl B. Satisfaction NOT FOR SALE NOT FOR SALE OR DISTRIBUTION C. Music therapy and satisfaction D. Satisfaction and type of delivery

10. Which statement by a fellow student best describes a confounding variable? A. “It can take on a wide range of values.” Jones & Bartlett Learning, © Jones & Bartlett Learning, B. “A variable thatLLC is restricted to whole numbers.” describes the characteristics of the study subjects.” OT FOR SALEC. OR“ItDISTRIBUTION NOT FOR SALE OR DISTRIB D. “A variable that can’t be controlled.”

11. Which of the following best represents a dichotomous variable? A. Blood pressure Age at death lett Learning,B. LLC © Jones & Bartlett Learning, LLC C. Gender E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION D. Weight

12. Which of the following represents a simple hypothesis? A. Exposure to pet therapy increases appetite in elderly patients. B. Family support and positive attitude decrease symptoms of dysreflexia in © Jones &cord Bartlett LLC © Jones & Bartl spinal injuredLearning, patients. NOT FOR SALE NOT DISTRIBUTION C. FOR Social SALE support, OR balanced diet, and regular exercise decrease the incidence of postpartum depression. D. Daily exercise and eliminating carbohydrates from the diet will result in a significant weight reduction in obese diabetic patients.


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© Jones & Bartlett Learning, LLC © Jones & Bartl NOT FOR SALE NOT FOR ORbetween DISTRIBUTION 13. What is theSALE difference a null hypothesis and a directional hypothesis? A. One is a declarative sentence; the other is a question. B. One assumes a relationship; the other denies that one exists. C. One is researchable; the other is statistical. D. One includes atLLC least two variables; the other © does not. & Bartlett Learning, Jones

Jones & Bartlett Learning, OT FOR SALE OR DISTRIBUTION NOT FOR OR DISTRIB 14. Which statement best represents the relationship between a causalSALE and an associative hypothesis? A. They are the opposite of each other. B. One is written in as a question, the other as a declarative sentence. One assumes a relationship, the other denies that one exists. Learning,C. LLC © Jones & Bartlett Learning, D. They are similar to each other.

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15. An operational definition of a variable is one that is: A. Broad and abstract. B. Narrow and abstract. C. Concrete and continuous. © Jones & Bartlett Learning, LLC D. Narrow and concrete.








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Discussion Questions


1. You work in a cardiology clinic that treats patients who have coronary artery disease and are recovering from a myocardial infarction. Many of these patients LLC have hypertension and are overweight, and you have noticedLearning, Jones & Bartlett Learning, © Jones & Bartlett that some of them have more difficulty following their medical regimens OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB than others. You want to develop a research study to investigate this problem. How would you go about doing so? What would be a possible problem statement? 2. You are a BSN student enrolled in a research course. The instructor has statement: “Does completion of a manlett Learning, LLCgiven you the following problem © Jones & Bartlett Learning, LLC datory health promotion course theSALE incidence of smoking cessation E OR DISTRIBUTION NOTaffect FOR OR DISTRIBUTION among college students who smoke?” Develop four hypotheses that might be drawn from this problem statement: a null hypothesis, a directional hypothesis, a nondirectional hypothesis, and an associative hypothesis. Can all of these hypotheses be developed? If any of them cannot be developed, why not? © Jones & Bartlett Learning, LLC © Jones & Bartl ReadSALE the following abstract and then provide the following information: NOT FOR SALE NOT 3. FOR OR DISTRIBUTION A. Identify the population of interest. B. Identify the variables. C. Construct a research question that could have guided this study. D. Construct a null hypothesis. E. Construct LLC a directional hypothesis. Jones & Bartlett Learning, © Jones & Bartlett Learning,

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Abstract: Hypertension Treatment and Control Within an Independent Nurse Practitioner Setting Objective: To assess blood pressure (BP) control among patients with hypertension managed by nurse practitioners (NPs) versus physicians. study. lett Learning, LLC Study Design: Cross-sectional © Jones & Bartlett Learning, LLC Methods: Retrospective medical record reviews were conducted at 3 indeE OR DISTRIBUTION NOT SALE ORpractices. DISTRIBUTION pendent NP-based practices and atFOR 21 physician-based Investigators at each practice identified a sample of patients 18 years or older with a hypertension diagnosis. The primary outcome was controlled BP. Results: The propensity score-matched cohort (623 in each group) had baselineLearning, characteristics.LLC Among the NP cohort, 70.5%© had con- & Bartl © Jonessimilar & Bartlett Jones trolled BP compared with 63.2% among the physician cohort; the mean NOT FOR SALE NOT FOR SALE OR DISTRIBUTION number of antihypertensive medications was lower among NP-treated patients. The adjusted odds of controlled BP were slightly lower for physician-treated patients. Conclusions: Comparable controlled BP rates were observed among patients with hypertension receiving care from an NP versus a compariJones & Bartlett Learning, LLC © Jones & Bartlett Learning, son group receiving care from a physician; the groups had similar OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIB baseline characteristics. Our findings support the increasingly important role of NPs in primary care (Wright, Romboli, DiTulio, Wogen, & Belletti, 2011).

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Suggested Readings

Beitz, J. (2006). Writing the researchable question. Journal of Wound, Ostomy, & Continence Nursing, 33(2), 122–124.

Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, Fineout-Overholt, E., Melnyk, B., & Schultz, A. (2005). Transforming OT FOR SALEhealth OR DISTRIBUTION NOT FOR SALE care from the inside out: Advancing evidence-based practice in OR DISTRIB the 21st century. Journal of Professional Nursing, 21(6), 335–344. Hudson-Barr, D. (2005). From research idea to research question: The who, what, where, when and why. Journal for Specialists in Pediatric Learning,Nursing, LLC 10(2), 90–92. © Jones & Bartlett Learning,

lett LLC E OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Law, R. (2004). From research topic to research question: A challenging process. Nurse Researcher, 11(4), 54–66. Library of Washington. (n.d.). The basics in research 101 [Archived]. Retrieved from http://guides.lib.washington.edu/content.php?pid=55083& sid=2465031 Jones & Bartlett Learning, LLC © Jones

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References


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